Liver

Question 1

What happens to the liver when disease/damage is chronic?

Answer 1

The liver becomes cirrhosed.
You get scarring and fibrosis of the liver.

Question 2

What are the effects of liver cirrhosis?

Answer 2

There is a huge blood supply from the gut to be metabolised and detoxified by the liver. With scarring/fibrosis, the blood supply can’t pass as well through the liver so this means:
- The liver can’t metabolise as effeciently.
- Can’t produce CFs, bile etc as effeciently
- Doesn’t itself recieve a good blood supply

Question 3

How can we try to prevent liver disease?

Answer 3

Give hepatitis vaccines
Advise reduction in alcohol
Limit on OTC paracetamol

Question 4

How do we manage Hepatitis?

Answer 4

Nutrition: Make sure getting right amount of fat absorbed & take fat soluble vitamins.
Drug: don’t prescribe normal amount of paracetamol to someone with active liver failure
Optimise remaining liver function
Transplant

Question 5

Where does blood from the gut drain?

Answer 5

Into liver via the portal venous system.
Liver hepatocytes filter and metabolise drugs & nutrients in blood before releasing into systemic circulation via hepatic vein –> vena cava.

Question 6

What are the roles of the following in the liver:
Portal vein
Hepatic vein
Hepatic artery
Hepatic duct

Answer 6

Portal vein - brings in blood from gut to be filtered.
Hepatic vein - takes filtered blood from liver to VC
Hepatic artery - provides O2 blood supply to liver
Hepatic duct - collect bile produced by hepatocytes to be stored in GB

Question 7

What are the functions of the liver?

Answer 7

1. Filtering/metabolising microbes/toxins
2. Metabolises drugs & nutrients
3. Exocrine = Bilirubin, Bile salts, Cholesterol
4. Synthesis = CFs, Abs, Albumin